Nadia Quiz 3 Study PDF

Intro to module 1 Wounds secondary to pathology (different from traumatic wounds) vascular wounds (arterial/venous insufficiency ulcers) diabetic (neuropathic) wounds pressure ulcers Vascular Wounds: Arterial Insufficiency Ulcers um Arterial system high pres...

Intro to module 1 Wounds secondary to pathology (different from traumatic wounds) vascular wounds (arterial/venous insufficiency ulcers) diabetic (neuropathic) wounds pressure ulcers Vascular Wounds: Arterial Insufficiency Ulcers um Arterial system high pressure (120 mmHg) back pressure to propel blood fwd starting at arteries to heart decrease as move distal and to capillaries Risk factors of arterial insufficiency ulcers atherosclerosis OVD Diabetes Obesity smoking HTN Age CVD Prognosis better - Ankle Brachial Index ABI >0.5 - toe pressure of 50 mmHg - transcutaneous O2 levels >30 mmHG poor prognosis - if wound doesn’t decrease in size or heal within 2 weeks need to POC  ALL OPEN WOUNDS REQUIRE A PULSE EXAMINATION Know chart !! Capillary Refill Test Pt postion: supine/sit normal: blood returns in 3 sec or less +; longer than 3 sec = vascular status impaired Venous Filling Time normal: 15-20 sec Arterial Insufficiency: >15-30 sec Rubor of Dependency Test normal: color returns to foot in 15 sec arterial insufficiency: color returns after 30 sec and turns bright red Infection control ischemic wounds prone to bacterial infxn may need bacterial swab if classical signs not shown topical tx: silver dressing, cadexomer iodide deep tissues: systemic antibiotic therapy Wound cleansing some wound cleaners toxic so only use on super infected ones least harmful is 0.9% saline Dressing arterial ulcers - minimal exudate, surrounding skin fragile use moist, non adherent dressing with antimicrobial properties Precautions for pts with arterial insufficiency avoid high compression (30-40 mmHg) with pts with ABI of more than 0.80 avoid compression dress for pt with ABI more than 0.50 REFER OUT TO VASCULAR SURGEON avoid using sharp things to remove debris with low ABI (70 yo impaired sensation: w/o pain as an early warning sign of developing tissue ischemia, pts are unlikely to shift themselves to alter pressure distribution; sci, spina bifida, stroke, full thickness burns & peripheral neuropathy impaired mobility: bc of hospitalization, dx, sci and infants/neonates. usually w/in 3 wks & 1 wk after surgery, metal status & admission to nursing home previous pressure ulcer: scar tissue goes back to 80% strength- scar tissue + pressure injury = way less tolerance and external load other risks: ppl w DBP